Advanced Burn Life Support (ABLS) Provider
Examination DEFINED ANSWERS LATEST
ALREADY GRADED A+ (2025/2026)
1. The initial step in the emergency management of a burn patient, before evaluating the burn wound
itself, is to:
A) Apply cool compresses to the burn to stop the burning process.
B) Remove all burned clothing and begin estimating burn size.
C) Stop the burning process, ensure scene safety, and assess the airway, breathing, and circulation
(ABCs).
D) Apply a topical antibiotic cream to the burn.
Answer: C
Rationale: The burn patient is a trauma patient. ABLS prioritizes the primary survey (ABCDEs) identical to
ATLS guidelines: Airway, Breathing, Circulation, Disability, and Exposure/Environment. Halting the
burning process is an A-B-C task, not just a wound care task.
2. Which of the following is an early sign of an inhalation injury in a patient with a burn sustained in an
enclosed space fire?
A) Blistering of the oral mucosa.
B) Singed nasal hairs, carbonaceous sputum, and hoarseness.
C) Cherry-red skin color.
D) Immediate blistering of the face.
Answer: B
Rationale: The triad of singed nasal hairs, carbonaceous sputum, and hoarseness/stridor is
pathognomonic for smoke inhalation injury. These patients are at very high risk for upper airway edema
and require early elective intubation.
3. The "Rule of Nines" estimates the body surface area (BSA) of an adult's entire head and neck as:
,A) 4.5%
B) 9%
C) 18%
D) 1%
Answer: B
Rationale: In the adult Rule of Nines, the head and neck = 9%, each arm = 9% (anterior 4.5%, posterior
4.5%), anterior trunk = 18%, posterior trunk = 18%, each leg = 18% (anterior 9%, posterior 9%), and
perineum = 1%.
4. A patient presents with a full-thickness burn to the entire left arm and a superficial partial-thickness
burn to the entire anterior trunk. Using the Rule of Nines, the approximate TBSA burned is:
A) 18%
B) 27%
C) 36%
D) 45%
Answer: B
Rationale: Left Arm = 9%. Anterior Trunk = 18%. 9% + 18% = 27% TBSA. Only partial and full-thickness
burns are counted when calculating fluid resuscitation needs.
5. According to ABLS, a "major burn injury" requiring transfer to a verified burn center includes which of
the following criteria?
A) Any burn >5% TBSA.
B) Burns involving the face, hands, feet, genitalia, perineum, or major joints.
C) Any superficial (first-degree) burn over 20% TBSA.
D) A burn caused by hot tap water in an adult.
Answer: B
Rationale: The American Burn Association's referral criteria include burns to functional/cosmetic areas
(face, hands, feet, genitalia), full-thickness burns in any age group, and burns with concomitant trauma.
TBSA thresholds also apply (>10% partial/full thickness in adults over 50).
6. The "Parkland Formula" for initial burn fluid resuscitation calculates the volume of Lactated Ringer's
as:
,A) 2 mL x weight (kg) x %TBSA burned.
B) 4 mL x weight (kg) x %TBSA burned.
C) 6 mL x weight (kg) x %TBSA burned.
D) 1 mL x weight (kg) x %TBSA burned.
Answer: B
Rationale: The Parkland formula is 4 mL x body weight in kg x %TBSA of partial- and full-thickness burns.
Half of the calculated volume is infused over the first 8 hours (from the time of injury), and the second
half over the subsequent 16 hours.
7. A 70 kg patient sustains a 40% TBSA partial-thickness burn at 12:00 PM. The total 24-hour fluid
requirement by the Parkland formula is:
A) 5,600 mL
B) 11,200 mL
C) 8,400 mL
D) 2,800 mL
Answer: B
Rationale: 4 mL x 70 kg x 40% TBSA = 11,200 mL in the first 24 hours. The first half (5,600 mL) must be
given over the first 8 hours from time of injury.
8. The time of injury was 10:00 AM. The calculated Parkland fluid for the first 8 hours is 5,000 mL. The
patient arrives in the ED at 12:00 PM (2 hours post-burn). How should the first 8-hour volume be
adjusted?
A) Give the full 5,000 mL evenly over 8 hours starting at 12:00 PM.
B) Give the remaining 5,000 mL over the remaining 6 hours (between 12:00 PM and 6:00 PM).
C) Ignore the delay and start the IV at a standard maintenance rate.
D) Give half the dose, as transport time negates the need for the initial bolus.
Answer: B
Rationale: The clock starts at the time of injury. The first half must be infused by 10:00 AM + 8 hours =
6:00 PM. Since there are only 6 hours remaining in the window, the volume needed to catch up is 5,000
mL / 6 hours = ~833 mL/hr.
9. The preferred IV fluid for burn resuscitation, per the Parkland Formula, is:
, A) Normal Saline (0.9% NaCl).
B) Lactated Ringer's solution.
C) Dextrose 5% in water (D5W).
D) Hypertonic saline.
Answer: B
Rationale: Lactated Ringer's is preferred because its pH and electrolyte composition are closer to
physiologic levels. Large volumes of Normal Saline can cause hyperchloremic metabolic acidosis.
10. The gold standard for monitoring the adequacy of fluid resuscitation during the first 24 hours is:
A) Central venous pressure (CVP).
B) Urine output of 0.5 mL/kg/hr in adults (30-50 mL/hr).
C) Normalization of heart rate.
D) Maintenance of systolic blood pressure >120 mmHg.
Answer: B
Rationale: Fluid is titrated to urine output (UOP). UOP is the most reliable, practical indicator of end-
organ perfusion during the resuscitative phase. CVP and PAOP are unreliable due to massive volume
shifts.
11. A patient with a circumferential full-thickness burn of the chest has increasing difficulty breathing
and decreasing tidal volumes. The chest wall is tight and non-compliant. The priority intervention is:
A) Increase the fluid rate.
B) Escharotomy of the chest.
C) Intubation and ventilator adjustment.
D) Administration of a bronchodilator.
Answer: B
Rationale: A circumferential, inelastic eschar of the chest restricts chest wall motion, mimicking a
tension pneumothorax. Escharotomy (an incision through the eschar down to the subcutaneous fat)
releases the constriction and restores ventilation.
12. Escharotomy incisions are made:
A) Through the muscle fascia to release compartments.
Examination DEFINED ANSWERS LATEST
ALREADY GRADED A+ (2025/2026)
1. The initial step in the emergency management of a burn patient, before evaluating the burn wound
itself, is to:
A) Apply cool compresses to the burn to stop the burning process.
B) Remove all burned clothing and begin estimating burn size.
C) Stop the burning process, ensure scene safety, and assess the airway, breathing, and circulation
(ABCs).
D) Apply a topical antibiotic cream to the burn.
Answer: C
Rationale: The burn patient is a trauma patient. ABLS prioritizes the primary survey (ABCDEs) identical to
ATLS guidelines: Airway, Breathing, Circulation, Disability, and Exposure/Environment. Halting the
burning process is an A-B-C task, not just a wound care task.
2. Which of the following is an early sign of an inhalation injury in a patient with a burn sustained in an
enclosed space fire?
A) Blistering of the oral mucosa.
B) Singed nasal hairs, carbonaceous sputum, and hoarseness.
C) Cherry-red skin color.
D) Immediate blistering of the face.
Answer: B
Rationale: The triad of singed nasal hairs, carbonaceous sputum, and hoarseness/stridor is
pathognomonic for smoke inhalation injury. These patients are at very high risk for upper airway edema
and require early elective intubation.
3. The "Rule of Nines" estimates the body surface area (BSA) of an adult's entire head and neck as:
,A) 4.5%
B) 9%
C) 18%
D) 1%
Answer: B
Rationale: In the adult Rule of Nines, the head and neck = 9%, each arm = 9% (anterior 4.5%, posterior
4.5%), anterior trunk = 18%, posterior trunk = 18%, each leg = 18% (anterior 9%, posterior 9%), and
perineum = 1%.
4. A patient presents with a full-thickness burn to the entire left arm and a superficial partial-thickness
burn to the entire anterior trunk. Using the Rule of Nines, the approximate TBSA burned is:
A) 18%
B) 27%
C) 36%
D) 45%
Answer: B
Rationale: Left Arm = 9%. Anterior Trunk = 18%. 9% + 18% = 27% TBSA. Only partial and full-thickness
burns are counted when calculating fluid resuscitation needs.
5. According to ABLS, a "major burn injury" requiring transfer to a verified burn center includes which of
the following criteria?
A) Any burn >5% TBSA.
B) Burns involving the face, hands, feet, genitalia, perineum, or major joints.
C) Any superficial (first-degree) burn over 20% TBSA.
D) A burn caused by hot tap water in an adult.
Answer: B
Rationale: The American Burn Association's referral criteria include burns to functional/cosmetic areas
(face, hands, feet, genitalia), full-thickness burns in any age group, and burns with concomitant trauma.
TBSA thresholds also apply (>10% partial/full thickness in adults over 50).
6. The "Parkland Formula" for initial burn fluid resuscitation calculates the volume of Lactated Ringer's
as:
,A) 2 mL x weight (kg) x %TBSA burned.
B) 4 mL x weight (kg) x %TBSA burned.
C) 6 mL x weight (kg) x %TBSA burned.
D) 1 mL x weight (kg) x %TBSA burned.
Answer: B
Rationale: The Parkland formula is 4 mL x body weight in kg x %TBSA of partial- and full-thickness burns.
Half of the calculated volume is infused over the first 8 hours (from the time of injury), and the second
half over the subsequent 16 hours.
7. A 70 kg patient sustains a 40% TBSA partial-thickness burn at 12:00 PM. The total 24-hour fluid
requirement by the Parkland formula is:
A) 5,600 mL
B) 11,200 mL
C) 8,400 mL
D) 2,800 mL
Answer: B
Rationale: 4 mL x 70 kg x 40% TBSA = 11,200 mL in the first 24 hours. The first half (5,600 mL) must be
given over the first 8 hours from time of injury.
8. The time of injury was 10:00 AM. The calculated Parkland fluid for the first 8 hours is 5,000 mL. The
patient arrives in the ED at 12:00 PM (2 hours post-burn). How should the first 8-hour volume be
adjusted?
A) Give the full 5,000 mL evenly over 8 hours starting at 12:00 PM.
B) Give the remaining 5,000 mL over the remaining 6 hours (between 12:00 PM and 6:00 PM).
C) Ignore the delay and start the IV at a standard maintenance rate.
D) Give half the dose, as transport time negates the need for the initial bolus.
Answer: B
Rationale: The clock starts at the time of injury. The first half must be infused by 10:00 AM + 8 hours =
6:00 PM. Since there are only 6 hours remaining in the window, the volume needed to catch up is 5,000
mL / 6 hours = ~833 mL/hr.
9. The preferred IV fluid for burn resuscitation, per the Parkland Formula, is:
, A) Normal Saline (0.9% NaCl).
B) Lactated Ringer's solution.
C) Dextrose 5% in water (D5W).
D) Hypertonic saline.
Answer: B
Rationale: Lactated Ringer's is preferred because its pH and electrolyte composition are closer to
physiologic levels. Large volumes of Normal Saline can cause hyperchloremic metabolic acidosis.
10. The gold standard for monitoring the adequacy of fluid resuscitation during the first 24 hours is:
A) Central venous pressure (CVP).
B) Urine output of 0.5 mL/kg/hr in adults (30-50 mL/hr).
C) Normalization of heart rate.
D) Maintenance of systolic blood pressure >120 mmHg.
Answer: B
Rationale: Fluid is titrated to urine output (UOP). UOP is the most reliable, practical indicator of end-
organ perfusion during the resuscitative phase. CVP and PAOP are unreliable due to massive volume
shifts.
11. A patient with a circumferential full-thickness burn of the chest has increasing difficulty breathing
and decreasing tidal volumes. The chest wall is tight and non-compliant. The priority intervention is:
A) Increase the fluid rate.
B) Escharotomy of the chest.
C) Intubation and ventilator adjustment.
D) Administration of a bronchodilator.
Answer: B
Rationale: A circumferential, inelastic eschar of the chest restricts chest wall motion, mimicking a
tension pneumothorax. Escharotomy (an incision through the eschar down to the subcutaneous fat)
releases the constriction and restores ventilation.
12. Escharotomy incisions are made:
A) Through the muscle fascia to release compartments.
